A peripheral smear prepared at room temperature from a patient with acute hepatitis secondary to hepatitis C virus is shown. Her CBC included a hemoglobin of 12.2g/dl, RBC count of 0.78 × 10⁶/ul, hematocrit of 8.4%, MCV of 107.7 fl, MCH of 156 pg and a MCHC of 145g/dl. Extensive RBC agglutination secondary to the presence of Type II cryoglobulins is evident in this low magnification image. The cryoglobulin is composed of polyclonal IgG and monoclonal IgM complexes. The falsely abnormal RBC indicies obtained on the automated hematology analyzer are the result of RBC clumping resulting in a marked decrease in the number of RBCs that are counted.